In the areas of anesthesiology, emergency medicine, critical care, and resuscitation as well as other medical areas, one practitioner typically monitors ventilation, and provides airway management, for an unconscious patient. Airway management commonly involves ventilating a patient by holding a face mask over the patient's mouth and delivering oxygen with positive pressure. Such practices, while typically effective, can fail because the airway passages through which air may be drawn to the patient's lungs can easily become obstructed when the patient lies in a supine position. The airways are typically obstructed because the mandible tends to move downward relative to the maxilla, and the soft tissues in the throat tend to relax. As a result, contact of the tongue, the soft palate, and the epiglottis with the pharynx may occur which prevents air in the mouth and nose from reaching the lungs. Therefore, during positive pressure ventilation a practitioner must appropriately relieve the obstruction generated by the soft throat tissues to provide a patent airway to the lungs.
Practitioners often use a device, typically referred to as an oropharyngeal airway, in conjunction with a face mask to support positive pressure ventilation. The oropharyngeal airway is shaped to open the airway between the tongue and the pharynx within a patient's throat. Referring to FIG. 1, a prior art oropharyngeal airway 30 is shown positioned in the mouth and throat of an unconscious patient 10. The oropharyngeal airway 30 is typically a single piece device formed by a generally rigid plastic material. The oropharyngeal airway 30 includes symmetrical mandibular and maxillary flanges 32 and 34 that engage the lower and upper lips 12 and 14, respectively, to stabilize the device and to prevent overinsertion, a bite block 36 that engages and separates the lower and upper teeth 16 and 18, and a pharyngeal section 38 that lifts the tongue 20 off the pharynx 22 and opens the airway. The pharyngeal section 38 is designed to closely match the shape of the tongue 20 and other tissues and, as shown in FIG. 1, properly engages the tongue 20 when the mandibular and maxillary flanges 32 and 34 engage the lips 12 and 14. The pharyngeal section 38 also typically includes an internal channel 40, or alternatively, the oropharyngeal airway 30 is I-shaped to provide a passageway through which air may pass to the lungs. The oropharyngeal airway 30, while effective for removing obstructions in some situations, has several drawbacks. For example, the pharyngeal section 38 only lifts the tongue 20 off the pharynx 22, and the epiglottis 24 may contact the pharynx 22 and obstruct the airway.
Practitioners often use a technique in which the mandible is advanced to move the epiglottis and the base of the tongue in a supine unconscious patient and clear the obstruction in the airway. One such technique, known as the jaw thrust, simply involves lifting or advancing the mandible upward relative to the maxilla. Another technique, known as the chin lift/head extension, involves rotating the head backwards while pulling the chin up. Another technique, known as the triple airway maneuver, is used by practitioners and involves three steps: lifting the mandible upward, opening the mouth, and rotating the top of the head backwards. The triple airway maneuver combines the motions of jaw thrust and chin lift/head extension techniques, and therefore, may be simply described as jaw thrust, mouth open, and head extension. Techniques such as the triple airway maneuver are recommended in emergency procedures, and as a result, are well-known by trained medical practitioners. However, the triple airway maneuver is complex and is not applied with a face mask to support positive pressure ventilation. In addition, the triple airway maneuver cannot be properly used with a conventional oropharyngeal airway due to the shape of the device and the symmetrical flanges that limit the advancement of the mandible to position the inferior teeth anterior to the superior teeth.
In addition, use of the triple airway maneuver is currently limited to situations in which two practitioners are available to ventilate the patient. Two practitioners are required because one of the practitioners must perform the triple airway maneuver and then hold the patient in a ventilation position using both hands. The other practitioner then ventilates the patient by squeezing a self-inflatable resuscitator bag. Two practitioners may be available for planned treatments, but in most cases, such as emergent and rescue situations, typically only a single practitioner is present.
Considering the limitations of previous designs, it would be desirable to have an oropharyngeal airway that may be used in conjunction with techniques such as the triple airway maneuver and face mask ventilation to ensure proper ventilation of a patient. It would also be desirable to have an oropharyngeal airway that permits a single practitioner to apply the aforementioned techniques.